Treatment of visual loss in pseudotumor cerebri associated with uremia.
Ten patients with pseudotumor cerebri associated with renal insufficiency had papilledema and elevated intracranial pressure, but neurologic examinations and CT were normal. The 40% frequency of severe visual loss, 20/100 or worse, was higher than expected for pseudotumor cerebri. While furosemide was effective in 3 patients with renal transplants, administration of corticosteroids to 2 other patients did not halt progressive loss of vision. The visual function of 2 patients deteriorated even after lumboperitoneal shunting. Five patients underwent fenestration of the optic nerve sheath. This procedure improved the visual acuity of 3 patients and stabilized vision in the others. While the pathogenesis of pseudotumor cerebri in renal insufficiency is unknown, optic nerve sheath fenestration is the surgical treatment of choice for visual loss unresponsive to medical therapy.
Guy
J
J
Department of Ophthalmology, University of Florida, Gainesville 32610.
Johnston
P K
PK
Corbett
J J
JJ
Day
A L
AL
Glaser
J S
JS
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001766:Blindness / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D002648:Child; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000601:surgery; D010211:Papilledema / Q000601:surgery; D011559:Pseudotumor Cerebri / Q000150:complications*; D014511:Uremia / Q000150:complications*; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity
D000305:Adrenal Cortex Hormones; D005665:Furosemide